Treatment of Sudden Sensorineural Hearing Loss: An Updated Review of the Literature

Background and Aim: The aim of this study is to review the current approaches on the treatment of sudden sensorineural hearing loss (SSNHL).

Materials and Methods: Results of an extensive literature search, including most electronic data bases (Medline, etc.) and medical books, were used as scientific sources to identify review articles and randomized control trials published between January 1990 and December 2008 in the English literature on the treatment of SSNHL.

Results: Intravenous (systemic) corticosteroids have been considered to be an acceptable treatment for SSNHL for many years. However, the latest reviews of the literature don't show any significant difference in hearing improvement between patients treated with steroids and patients treated with placebo. The role of antiviral agents is also controversial, as a few recent reviews support that they are ineffective. Intratympanic corticosteroids are considered to be a feasible choice, whether combined with systemic steroids or not. Finally, with regard to the use of hyperbaric oxygen, recent studies support that, considering the cost of therapy and its inconvenience to the patients, this treatment should only be considered in patients suffering SSNHL if there are contraindications to standard treatment.

Conclusions: Although SSNHL is a quite common condition for otolaryngologists, its treatment still remains controversial. The evaluation of treatment protocols, as well as the comparison between different studies, is very difficult, mainly due to the variety of the therapeutic protocols, the complicated etiopathogenesis of the disease, and the significant rate of spontaneous recovery. The review of the recent literature shows that no randomized control trials exist to determine effective treatment.